Young adults with autism increase empathic communication with training

At the Hussman Institute for Autism, we see evidence of empathy every day among people with autism. Individuals on the autism spectrum experience powerful emotions and demonstrate concern for others. Many self-advocates on the autism spectrum report being overly in-tune with the emotions of the people around them, sometimes to such a degree that it is overwhelming. In our view, there is no need to teach individuals with autism how to feel empathy. However, it can be challenging for individuals with autism to express their empathy.

Think about it:

During a typical conversation, each partner is expected to simultaneously interpret non-verbal cues such as facial expressions and body language, process spoken language, and then immediately and spontaneously generate an appropriate response, all while blocking out distracting background noise and other sensory stimuli.

The training:

The success of “empathic communication training” demonstrates that empathic communication is a teachable skill. That’s important, because often this skill is not intuitive for individuals on the autism spectrum. Lacking empathic communication skills can reduce the likelihood of forming stable, reciprocal relationships, which are critical to overall well-being for all people.

Empathic communication training gives individuals a chance to practice offering empathic responses during social conversation with a clinician. It also gives them the opportunity to review themselves, via video, providing empathic and non-empathic responses and to receive feedback. A three-step framework (Figure 1) helps them generalize their new communication skill to any situation: identify a partner’s statement containing an emotion, express understanding, and ask a relevant question.

A 2016 study of empathic communication training at the Koegel Autism Center at the University of California, Santa Barbara included three young adults (ages 19 to 26) on the autism spectrum: John, Peter, and Dan. All were verbal and had significant social challenges. They participated in 40-minute training sessions once per week for 10 weeks. They spent 30 minutes of each session reviewing video from the previous week and getting feedback from the clinician. Then they practiced empathic communication in conversation with a clinician during the last ten minutes.

The outcomes:

Before the training, John only used empathic statements 5.6 percent of the time in response to a statement of emotion (“I’m excited”, “I’m nervous”, I’m not feeling well”) by the clinician during conversation. Afterward, that increased to 79 percent. At both one month and two year follow-ups, he used empathic statements at every appropriate opportunity (100 percent). Peter never used empathic statements before the intervention. Afterward he used them 71 percent of the time. At a one-month follow-up, he had dropped slightly to 50 percent; he wasn’t available for a two-year follow-up. Dan used empathic listening statements 37 percent of the time initially, but after training used them 87 percent of the time. At the one-month follow-up he was at 82 percent, and 50 percent after two years. All three participants demonstrated similar gains in use of empathic questions.

Not only for researchers:

Parents and teachers may consider using the three-step framework with their children and students. Even without a formal 10-week program, using the framework in an informal way with one’s children, students, or for oneself might lead to gains in empathic communication. Simply knowing the framework is not enough, though; it’s equally important that individuals have frequent opportunities to practice communicating empathy with peers.

Though the number of subjects in this study is relatively small, the results are encouraging. Empathic communication can be important for building meaningful relationships, which are critical for life satisfaction.

Sarah Hansen is the Communications Associate at the Hussman Institute for Autism. She works to share the Institute's research and programs with families, educators, and anyone else interested in learning more about how to support individuals with autism. She holds a Master of Science in Biological Sciences from University of Maryland, Baltimore County (UMBC) and Master of Arts in Teaching and Bachelor of Science degrees from Cornell University. Before joining the Hussman Institute, she taught middle and upper school science at the Holton-Arms School in Bethesda, MD.